Low-dose mannitol (0.3 g kg(-1)) improves the pulsatility index and minimum diastolic blood flow velocity in traumatic brain injury

• Published in: Brain injury Vol. 29; no. 6; p. 766
• Main Authors: Nincevic, Zeljko, Mestrovic, Julije, Nincevic, Jasna, Sundov, Zeljko, Kuscevic, Dorjan
• Format: Journal Article
• Language: English
• Published: England 01.06.2015
• Subjects: Adult; Aged; Aged, 80 and over; Blood Flow Velocity - drug effects; Blood Pressure - drug effects; Brain Injuries - diagnostic imaging; Brain Injuries - drug therapy; Brain Injuries - physiopathology; Dose-Response Relationship, Drug; Female; Glasgow Coma Scale; Humans; Male; Mannitol - administration & dosage; Middle Aged; Middle Cerebral Artery - drug effects; Middle Cerebral Artery - physiopathology; Pulsatile Flow - drug effects; Ultrasonography, Doppler, Transcranial; transcranial Doppler ultrasonography; traumatic brain injury; minimum diastolic blood flow velocity; pulsatility index; Low-dose mannitol
• ISSN: 1362-301X
• DOI: 10.3109/02699052.2015.1004743

The aim of the study was to investigate the effects of using low-dose mannitol (0.3 g kg(-1)) on the pulsatility index (PI) and minimum diastolic blood flow velocity (FV-min) of the middle cerebral artery in a traumatic brain injury (TBI). Low-dose mannitol (0.3 g kg(-1)) was administered to a group of 20 patients with a TBI. Transcranial Doppler (TCD) ultrasonography was used to monitor the PI and FV-min. The study included patients with a diffuse traumatic brain injury and Glasgow coma score < 8. The initial TCD ultrasonography values were pathological (PI > 1.4 and FV-min < 20 cm s(-1)). TCD ultrasonography examinations were carried out before mannitol administration, immediately after administration and 1, 2 and 3 hours after the administration of mannitol. A one-way analysis of variance revealed significant changes in the PI (F = 8.392; p < 0.001) and FV-min (F = 8.291; p = 0.001) after the use of mannitol. Low-dose mannitol administration appears to be efficacious for improving the indicators of disturbed circulation in a TBI (FV-min increase, PI decrease). The maximum decrease in the PI was recorded 1 hour after the administration of mannitol and was 10.9% of the initial value. The maximum increase in the FV-min was recorded 1 hour after administration and was 29.7% of the initial value. These changes were significant ∼ 2 hours later.